How do you maintain your balance during activity?
A brief overview of your vestibular, proprioceptive and visual systems that help keep you upright
There are 3 systems that help you to stay balanced when you are completing your daily activities. These systems are your vestibular system (your inner ear), your vision, and your proprioceptive system (joint, muscle and tendon receptors). They work together to help you move in space, stay upright, and recover well when you do get off-balanced. If one system is not working as well as the others, then the other systems can become more attuned to changes in your position to help keep you from falling or losing your balance easily.
The vestibular system in the inner ear has the ability to orient your head and body in space to keep your eyes on the horizon. There are structures in the inner ear that detect both straightaway movement in vertical and horizontal patterns as well as rotational movement of the head. They also detect head tilt and acceleration of the head. The sensory information from the vestibular system gets sent to the brain stem and cerebellum in the brain to allow for coordinated postural reflexes and controlled eye movement related to head movement. The bones in the inner ear are adult-sized at birth and the only fully myelinated (a protective covering around nerves that help the nerves transmit information quickly and efficiently) and fully functioning part of the central nervous system at birth (from Jan Tecklin, Pediatric Physical Therapy). Problems with the inner ear/vestibular system can produce symptoms including dizziness, balance problems, and vertigo (room spinning). Nausea and motion sickness can also be symptoms.
The visual system gives your brain information about how you are moving relative to your environment as well as how your environment is moving relative to your body. When you have vision in both eyes, you have signals from your eyes providing depth perception and when both eyes work well together, you have improved, clear vision without double vision or blurred vision. The occipital lobe sits in the back of the brain above the cerebellum and this is where our visual signals get processed. When the visual system is not working well, it can affect our balance and cause dizziness. Most commonly, this is due to concussion, eye misalignment (when the eyes don’t move synchronously), stroke, or head injury.
The proprioceptive systems are receptors in the joints, muscles, and tendons that provide sensory information to the brain to tell your brain where your body is in space. This information travels through the spinal cord, brain stem and to the cerebellum to be processed in the brain. The proprioceptive system also helps to regulate tension and force needed to carry out a task. When this system is not working well, there is no dizziness associated with dysfunction. Instead, there is ataxia, which is uncoordinated movement of the limbs. The proprioceptive system allows us to walk without looking down at our feet or to touch our finger to our nose with our eyes closed. Activities that can engage our proprioceptive system include heavy lifting, pushing or pulling objects, hugging, jumping, crawling, handwriting,, playing sports, and carrying objects.
If you are having problems with your balance, I would suggest getting your eyes examined, going to an audiologist to check your hearing, going to an ENT specialist (ear, nose and throat) who is typically a medical doctor, or a physical or occupational therapist who can test your proprioceptive system. Knowing which system is not working well is the first place to start. You may find that one or more systems are not functioning well and it is all contributing to your balance and risk of falls.
Take good care,
Sharon
PS: If you’re interested in learning techniques to help each of these systems, stay tuned! The next few newsletters will focus on these issues! If you haven’t subscribed, please do, so you’ll be notified as soon as they are released!